Individual provider Active NPI

Brendan P. Rooney, CO

  • Customized Equipment (DME)
  • New Paltz, NY
National Provider Identifier
1811062631
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Practice address
243 Main St
Suite 260
New Paltz, NY 12561-1350
Phone
(845) 255-2929
Fax
(845) 255-7405
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

243 Main St
Suite 260
New Paltz, NY 12561-1350

Mailing address

243 Main St
Suite 260
New Paltz, NY 12561-1350
Phone (845) 255-2929

Other identifiers 1

IdentifierTypeStateIssuer
02119666MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930041111 NY DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 8426169384 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Highland, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1811062631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 MAIN ST",
            "address_2": "SUITE 260",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611350",
            "telephone_number": "845-255-2929",
            "fax_number": "845-255-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 MAIN ST",
            "address_2": "SUITE 260",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611350",
            "telephone_number": "845-255-2929",
            "fax_number": "845-255-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROONEY",
        "first_name": "BRENDAN",
        "middle_name": "P.",
        "credential": "CO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02119666",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.